Dr Raga Deepika Chakravarthula

  chief complaints- C/O RIGHT UPPER AND LOWER WEAKNESS SINCE MORNING ON 16/04/24 AND SLURRING OF SPEECH SINCE MORNING ON 16/04/24 HOPI: PT WAS APPARENTLY ASYMPTOMATIC 1 DAY BACK THEN HE DEVELOPED RIGHT UPPER LIMB AND L0WER LIMB WEAKNESS SINCE MORNING ON 16/04/24 . SUDDEN ONSET NOT A/W INVOLUNTARY MOVEMENTS ,NO FROTHING FROM MOUTH, INVOLUNTARY MICTURITION,INVOLUNTARY DEFECATION C/O, SLURRING OF SPEECH SINCE MORNING ON 16/04/24 AND DEVIATION OF MOUTH TO LEFT SIDE NO H/O FEVER COUGH,COLD, ALLERGIES NO H/O ABDOMINAL PAIN, NAUSEA, VOMITING,LOOSE STOOLS. NO H/O CHEST PAIN PALPITATIONS,SOB,SWEATING NO H/O PEDAL EDEMA,DECREASED URINE OUTPUT K/C/O HTN SINCE 25 YRS AND IS ON TAB.AMLODIPINE 5 MG+TAB.TELMISARTAN 40 MG+TAB.HYDROCHLORTHIAZIDE 12.5MG OD K/C/O BRONCHIAL ASTHMA SINCE 25 YRS AND IS ON INHALER FORMONIDE 1 PUFF [SOS] PAST HISTORY N/K/C/O TB,DM2,EPILEPSY,CVD,CAD ON EXAMINATION: PT IS CONSCIOUS,COHERENT,COOPERATIVE NO PALLOR ,ICTERUS,CYANOSIS,CLUBBING,LYMPHADENOPATHY,PEDAL EDEMA TEMP: AFEBR

57 year old female gardener resides near Sanghi ( hayathnagar) Presented with C/o fever since 3 days, high grade, continuous, with chills, relieved with medication,  pain in epigastrium since 3days, non radiating, not associated with burning, belching, associated with  one episode of vomiting, with food content, non bilious, non projectile, non blood stain No h/o chest pain, breathlessness, giddiness, palpitations, orthopnea,pnd,cough, cold, burning micturition, loose stools She's second born child ,whose father was toddy tree climber and has daily habit of consumption of toddy. She was made to start toddy consumption at very young age of 4-5years considering it to be good for health And consumes daily 1glass of toddy thrice everyday for 15 years  Works as farmer from age of 22 years at chittaluru near chitiyal ,Married and moved to hyderabad near seethaphalmandi. Stopped consuming toddy after marriage  And stopped working for some time after her marriage. At age of 23 years- pati